GnRHa誘導破卵懷孕率比hCG低

OHSS死亡率約3/100000
使用GnRHa誘導破卵雖能下降OHSS
但其懷孕率比使用hCG誘導破卵懷孕率為低
同時GnRHa可能干擾子宮內膜影響胚胎著床
與其要減低COH劑量(coasting)不如使用GnRHa誘導破卵並將全數胚胎冷凍待下一週期植入可達較佳懷孕率
http://humrep.oxfordjournals.org/content/26/10/2593.full


In the first randomized controlled trials comparing GnRH agonist triggering and hCG administration, the pregnancy rates were significantly decreased in the agonist triggered condition (Humaidan et al., 2005; Kolibianakis et al., 2006). GnRH agonist triggering has a combined negative effect on the function of the corpus luteum and on the function of the endometrium (Humaidan et al., 2005, 2009). 

An OHSS-Free Clinic by segmentation of IVF treatment

1. Paul Devroey*, 
2. Nikolaos P. Polyzos and 
3. Christophe Blockeel

+Author Affiliations

1. Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium

1. ↵*Correspondence address. Tel: +32-477-380889; Fax: +32-2-477-6649; E-mail:paul.devroey@uzbrussel.be

 

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Abstract

Published data indicate a significant increase in ovarian hyperstimulation syndrome globally. The occurrence of approximately three maternal deaths per 100 000 stimulated women has been reported, and extrapolation of these figures to a global situation would give an impressive number. The syndrome can be erased by applying ovarian stimulation using the combination of GnRH antagonist with GnRH agonist to trigger ovulation. In this case, the strategy is to freeze all of the oocytes or embryos for later use.